Bleeding and cramps are some of the most common – and normal – symptoms of early pregnancy. But, of course, it can still be scary when one or the other happen to you. And, it has to be said, there is sometimes a more serious reason when it does.
“Both bleeding and cramps can be alarming,” says our expert GP Dr Rob Hicks, “but the vast majority of pregnant women who experience them go on to have a healthy full-term pregnancy.
“That said, it’s understandable that you’re worried and it is always important to mention a bleed or cramping to your midwife or doctor, so that they can rule out any problems.”
You should definitely contact your GP or your midwife if:
- Any cramps are accompanied by tenderness low down in your belly
- Any bleeding is heavy or contains pink or grey clots
- The cramping pain is very sharp (particularly if it’s on 1 side) or severe, and lasts for more than 24 hours
- You have bright red bleeding and cramps at the same time
- You also feel very dizzy, faint, feverish or nauseous
Why am I bleeding – and what should I do?
Most likely, you’re bleeding as a result of your body adjusting to pregnancy: maybe your shifting hormonal balance is bringing on some breakthrough bleeding or, if you’re about 6 to 12 days post-conception, you may be experiencing some ‘implantation bleeding‘ as your fertilised egg beds itself in to the lining of your womb. It’s also possible that you could have a vaginal infection.
With implantation bleeding and breakthrough bleeding, the bleeding is usually light and often brownish in colour. Both are worth mentioning to your midwife or GP.
If your bleeding is more like spotting and is happening over several days, you may have a vaginal infection – and should call your midwife or GP because, if it is an infection, it’ll need treating.
If your bleeding is heavy or bright red, especially if it is accompanied by pain, you should contact your GP or midwife straightaway.
Why am I getting cramps – and what should I do?
Mild abdominal cramps in early pregnancy can be caused by implantation bleeding and also by your womb – and the ligaments around it – beginning to stretch to accommodate your baby. These are worth mentioning to your midwife or GP but are rarely anything to worry about.
But if you have severe or persistent pains, then you should call your midwife or GP and get yourself checked out – especially if the cramps are accompanied by spotting, bleeding, vaginal discharge, fever, faintness or vomiting.
Severe cramps can be sign of something more serious. But, as our expert GP Dr Philippa Kaye can testify, by no means always…
“In my 1st pregnancy,” she says, “I was taken aback by how severe my cramps were in the early weeks, to the extent that I went to check it out with my doctor. That was the right thing to do – I’d always advise anyone to do the same. But in my case, and in lots of other cases, I was completely fine.”
What if it’s a miscarriage?
Sadly, it’s now known that miscarriage does happen in 1 in 4 pregnancies, and most miscarriages happen in the first 12 weeks of pregnancy. But bleeding and cramps do not, on their own, mean you are miscarrying or are going to.
As we’ve seen above, there are lots of other causes of bleeding and cramps that are either a normal part of pregnancy or that can be treated effectively without harm to your baby. In fact, it’s thought that, although between 20% and 40% of pregnant women experience bleeding, 75% of these pregnancies will continue to term.
But when you experience bleeding and cramping together – particularly if one or both are heavy/severe – then your midwife or doctor may well suspect a miscarriage. They’ll probably want to run some tests and do a transvaginal (internal) ultrasound before anyone can tell you for sure.
About our expert GP Rob Hicks
Rob is a GP with a special interest in family health. He has appeared as a medical expert on ITV’s This Morning and Good Morning Britain, Sky News, Channel 5 News, Channel 4 News, ITV News and BBC News, and is medical script adviser to the award-winning BBC1 drama series Doctors. He is also a highly skilled medical editor, contributing to the NHS website and WebMD. He lives in Greater London with his family.
Dr Philippa Kaye works as a GP in both NHS and private practice. She attended Downing College, Cambridge, then took medical studies at Guy’s, King’s and St Thomas’s medical schools in London, training in paediatrics, gynaecology, care of the elderly, acute medicine, psychiatry and general practice. Dr Philippa has also written a number of books, including ones on child health, diabetes in childhood and adolescence. She is a mum of 3.